Sleep disorders are complex and widespread, especially in western industrial countries, in which potentially a large number of adults have difficulties with getting regular sleep hours. Moreover, the disease lasts for years among at least half of the patients who suffer from sleep disorders. Among people with insomnia, postmenstrual women constitute an especially vulnerable group. Menopause-related sleep disorders deteriorate a woman’s emotional, physical, and psychological states by reducing the quantity of estrogen and progesterone (Drake et al., 2018). Consequently, finding the right treatment is necessary not just for treating insomnia, but also for improving overall patients’ life quality.
Sleep disorder lasting for many years that is the case for S.H., age 47. Common complaints in such cases include problems with falling asleep, awakenings during sleep, issues with returning to sleep, or awakening too early in the morning (Attarian, 2017). In the case of S.H., specific therapy goals to fight with the complaints would include improving the quality and quantity of sleep S.H. is getting and alleviation of daytime deteriorations that are related to menopause-related insomnia. Consequently, drug therapy would include Zolpidem prescription as it is taken just for up to four weeks, and short-term usage of such a clinically efficient agent is generally advocated for this reason. Zolpidem has been proved to have a positive effect on sleep latency and has little to no sedation effect (Attarian, 2017). In regards to the drug-food interaction, taking Zolpidem with food may interfere with its effect delaying the onset of sleep. In this way, it is better to take the drug after a meal allowing one’s organism to absorb the medication (Attarian, 2017). In rare cases, Zolpidem may cause memory loss and hallucinations. The appearance of these few and far between adverse reactions would lead to a change in pharmacotherapy.
Parameters for monitoring the therapy are applied to ensure the success of treatment. They include measuring quantitative and qualitative progress in total sleep time, sleep onset latency, sleep quality, and sleep maintenance (Barnes et al., 2017). Moreover, patient education is significant in ensuring the therapy success. It is necessary to inform the patient in regards to safety measures, potential adverse reactions to a specific drug and its interactions with others, treatment objectives, and prognosis. Consequently, the effectiveness of treatment and the presence of side effects would be measured by follow-up meetings with S. H. every two weeks.
In case if first-line insomnia treatment fails, revision of pharmacotherapy would follow. Cognitive behavioral therapy for insomnia (CBTI) is one of the most popular insomnia therapies. Drake et al. (2018) state that “higher remission rates and greater improvements in sleep maintenance suggest that CBTI may be a superior treatment option for most women” (p. 10). CBTI is helpful in controlling negative thoughts that may keep patients away from falling asleep (Drake et al., 2018). Usually, CBTI is considered to be as effective as sleep pharmacotherapy or even more so (Drake et al., 2018). It is also recommended that this one, as well as other insomnia therapies, should be combined with a healthy diet (minimizing sugar intake and consuming more food that contains tryptophan) and regular exercise (for instance, yoga can help to decrease cortisol levels). Even though this therapy reduces the need for medication, it may be combined with alternative medicines such as herbs. In the case of S.H., the root of valerian or chamomile could be helpful with the falling asleep processes and sleep quality.
Insomnia and sleep disorders are one of the chief complaints among women who go through or are at the beginning of their menopause. Insomnia may lead to dysfunctions in daily life and worsen overall quality of life. As a result, a large number of population suffers from sleep disorders’ effects that make women susceptible to depression and interfere with their mood. CBTI and Zolpidem have been proven to alleviate and successfully eliminate insomnia.
References
Attarian, H. P. (Ed.). (2017). Clinical handbook of insomnia. Springer.
Barnes, C. M., Miller, J. A., & Bostock, S. (2017). Helping employees sleep well: Effects of cognitive behavioral therapy for insomnia on work outcomes. Journal of Applied Psychology, 102(1), 104–113.
Drake, C. L., Kalmbach, D. A., Arnedt, J. T., Cheng, P., Tonnu, C. V., Cuamatzi-Castelan, A., & Fellman-Couture, C. (2018). Treating chronic insomnia in postmenopausal women: A randomized clinical trial comparing cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy, and sleep hygiene education. Sleep, 42(2), 1-11.